Laryngopharyngeal reflux disease in singers: Pathophysiology, clinical findings and perspectives of a new patient-reported outcome instrument

Lechien, Jérôme R.; Schindler, Antonio; Robotti, Carlo; Lejeune, L.; Finck, Camille

doi:10.1016/j.anorl.2018.08.008

Cited by 26 publications

(14 citation statements)

References 50 publications

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“…In addition, hoarseness related to reflux, which is due to modifications of the biomechanical properties of the vocal folds, may lead to vocal strain and muscle tension, reinforcing a cycle of increased occurrence of microtraumas. As suspected but not demonstrated, these mechanisms could primarily concern for voice professionals who are known to be at risk of LPR with regard to their lifestyle (e.g., stress, food habits) and voice overuse . Figure illustrates the demonstrated and suspected LPR mechanisms that may favor the development of BLVF.…”

Section: Discussionmentioning

confidence: 99%

“…As suspected but not demonstrated, these mechanisms could primarily concern for voice professionals who are known to be at risk of LPR with regard to their lifestyle (e.g., stress, food habits) and voice overuse. 52 Figure 2 illustrates the demonstrated and suspected LPR mechanisms that may favor the development of BLVF. From a theoretical point of view based on the current literature, these mechanisms may support the role of reflux in the development of some BLVF such as nodules, polyps, and Reinke's edema.…”

Section: Rfs >7mentioning

confidence: 99%

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Association between laryngopharyngeal reflux and benign vocal folds lesions: A systematic review.

et al. 2019

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Objectives To investigate the role of laryngopharyngeal reflux (LPR) in the development of benign lesions of the vocal folds (BLVF). Methods PubMed, Cochrane Library, and Scopus were searched by three independent investigators for articles published between January 1990 and November 2018 providing substantial information about the role of LPR in the development of nodules, polyps, cysts, Reinke's edema, and sulcus vocalis. Inclusion, exclusion, diagnostic criteria and clinical outcome evaluation of included studies were analyzed using Preferred Reporting Items for Systematic Reviews and Meta‐Analyses criteria. Results Of the 155 relevant publications, 42 studies were included. Thirty‐five were clinical studies and seven were experimental research studying the impact of reflux on vocal fold tissue. Only seven clinical studies utilized objective LPR diagnoses (pH monitoring), suggesting an association between LPR and the development of nodules, polyps, and Reinke's edema. These studies were characterized by a substantial heterogeneity due to discrepancies in inclusion/exclusion criteria, diagnostic methods, and clinical outcome evaluation. The few basic science studies on this topic support that LPR creates an environment that may predispose to BLVF through changes in defense mechanisms of the vocal folds, cell‐to‐cell dehiscence, inflammatory reaction of the vocal folds, and reaction to phonotrauma. Conclusions Caustic mucosal injury from LPR could cause increased susceptibility of the vocal fold mucosa to injury and subsequent formation of nodules, polyps, or Reinke's edema. However, the heterogeneity and the low number of high‐quality studies limit the ability to draw definitive conclusions. Future clinical and experimental studies are needed to better identify the role of reflux in development of BLVF. Laryngoscope, 129:E329–E341, 2019

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Section: Discussionmentioning

confidence: 99%

Section: Rfs >7mentioning

confidence: 99%

Association between laryngopharyngeal reflux and benign vocal folds lesions: A systematic review.

et al. 2019

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“…(5) Sleep disorder is also associated with mental and psychological disorders (17). Lechien et al (18) recognized that the risk of GERD was significantly and positively correlated with the severity of negative emotions, and a considerable part of the negative emotional effects were achieved through sleep disorders. This study showed that the HADS scores of patients with abnormal PSQI scores are lower than those of patients with normal PSQI scores, and there is a positive correlation between PSQI score and HADS scores.…”

Section: Discussionmentioning

confidence: 99%

Correlation and Influencing Factors Between Laryngopharyngeal Reflux Disease and Sleep Status in Patients

Liu

Xiao

et al. 2022

Front. Surg.

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ObjectiveTo observe the correlation between laryngopharyngeal reflux disease (LPRD) and patients' sleep status, and to explore the related factors of LPRD.MethodsFour hundred and sixteen patients who visited the otorhinolaryngology clinic in our hospital from June 2019 to June 2021 were selected as the research subjects. According to the scale of reflux symptom index, the subjects were divided into a patients group (120 patients) with an the reflux symptom index (RSI) > 13 and a control group (296 patients) with an RSI ≤ 13 according to the RSI scale score. General patient information was collected. The sleep state and emotional state of patients in the two groups were evaluated, and the related influencing factors for LPRD were also evaluated. The correlation between sleep state and depression in LPRD patients was analyzed.ResultsFour hundred and sixteen patients were divided into patients group and control group according to RSI score, the ratio of the two groups was 1:2.47. In the patients group, the common symptoms of RSI score and the top three of the total score were as follows: Foreign body sensation in throat in 112 patients, 438 points; Keep voice clear in 108 patients, 381 points; Excessive phlegm or nasal discharge reflux in 101 patients, 348 points. The PSQI and HADS scores in the patients group were higher than those in the control group (t = 19.990, 13.007, 14.690, P all <0.001). Logistic regression analysis showed that high-fat diet and high PSQI score were the risk factors for the development of LPRD (P = 0.012, P = 0.007). According to the PSQI score, the patients in the patients group were divided into 35 patients with abnormal PSQI score, 85 patients with normal PSQI score, and the HADS scores of those with abnormal PSQI score were all lower than those with normal PSQI score (P > 0.05). The PSQI score of the patients in the patients group was positively correlated with the HADS score (r = 0.714, P = 0.013).ConclusionSleep disorder may lead to the occurrence or aggravation of anxiety and depression in patients with LPRD, and it is an independent risk factor for the development of LPRD. Clinical attention to the treatment of sleep disorders in patients with LPRD may be conducive to improving the efficacy of LPRD.

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“…22 In addition, the development of hoarseness and benign lesions of vocal folds in LPR decrease communication and interaction effectiveness. 23 Because so much work requires verbal interaction, the influence of voice problems can reduce the social function, which is one domain considered when assessing the QOL. 11 The influence of psychological factors must also be considered.…”

Section: Discussionmentioning

confidence: 99%

Proton pump inhibitors effect on the quality of life of patients with laryngopharyngeal reflux

Tamin

Zulka

Yunizaf

et al. 2022

Oto Rhino Laryn Indones

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Background: Laryngopharyngeal reflux (LPR) is a condition caused by retrograde flow of gastric contents to the larynx, pharynx, trachea, and bronchus, which can affect patients’ quality of life (QOL). Purpose: To evaluate the effect of proton pump–inhibitor (PPI) therapy on the quality of life of patients with laryngopharyngeal reflux (LPR). Methods: This randomized controlled trial study involved 52 patients with dysphagia. The short-form REFLUX-QUAL® questionnaire was used to assess QOL. The patients were given lansoprazole twice daily as early diagnostic method as well as a therapy for LPR. If improvement found, PPI therapy was continued for two months. Afterwards patients was randomly divided into continuous therapy group (n = 25) or an on-demand therapy group (n = 27). Results: There was no significant difference in gender, age group, or economic level among subjects in both groups. Treatment with PPIs both continuously and on-demand significantly improved patients’ QOL from 44.83 ± 19.11 to 83.37 ± 11.51 (p <0.001). Significant improvements occurred in almost all of eight QOL domains as compared at the start of and six months into PPI therapy (p <0.001); discomfort remained the exception as patients with LPR must continue to avoid certain foods, (p = 0.233). However, there was no significant difference between the continuous and on-demand therapy groups concerning improvements in the quality of life (p = 0.281). Conclusion: Treatment with PPIs either continuously or on-demand for six months significantly improved patients’ quality of life, with no significant difference between the two treatment groups.Keywords: proton pump inhibitor, PPI, quality of life, laryngopharyngeal reflux, LPRABSTRAKLatar belakang: Refluks laringofaring (RLF) adalah kondisi terjadinya aliran balik isi lambung ke laring, faring, trakea, dan bronkus yang dapat mempengaruhi kualitas hidup pasien. Terapi empiris Proton Pump Inhibitor (PPI) merupakan pendekatan diagnosis dan metode terapi untuk RLF. Tujuan: Penelitian ini bertujuan untuk mengevaluasi efektivitas pengobatan PPI terhadap kualitas hidup pasien RLF Metode: Penelitian secara uji acak terkendali ini melibatkan 52 pasien dengan keluhan disfagia. Digunakan Reflux-Qual Short form (RQS) untuk menilai kualitas hidup subjek. Pasien diberikan lansoprazole dua kali sehari sebagai diagnosis dini dan terapi untuk refluks. Apabila terdapat perbaikan, PPI diteruskan selama 2 bulan, kemudian pasien dibagi menjadi 2 grup secara acak. Kelompok pasien yang mendapatkan terapi secara kontinu terdiri dari 25 pasien, sedangkan kelompok terapi on-demand terdiri dari 27 pasien. Hasil: Tidak terdapat perbedaan signifikan pada jenis kelamin, usia, tingkat ekonomi antara pasien pada kelompok terapi kontinu dan on-demand. Pengobatan PPI secara kontinu dan on-demand secara signifikan meningkatkan kualitas hidup pasien dari 44,83 ± 19,11 menjadi 83,37 ± 11,51 (p<0,001). Selain itu, terdapat perbaikan yang signifikan pada hampir semua dari delapan domain kualitas hidup pada bulan keenam terapi PPI dibandingk an awal terapi, kecuali pada domain ketidaknyamanan pasien karena pasien harus menghindari makanan tertentu (p = 0,233). Namun, tidak ditemukan perbedaan yang signifikan pada kelompok terapi secara kontinu dan on-demand pada peningkatan kualitas hidup (p = 0,281). Kesimpulan: Pengobatan PPI secara kontinu dan on-demand selama 6 bulan secara signifikan meningkatkan kualitas hidup pasien RLF. Namun, tidak ada perbedaan yang signifikan antara kedua kelompok tersebut terhadap peningkatan kualitas hidup.Kata kunci: penghambat pompa proton, PPI, refluks laringfaring, refleks laringofaring, kualitas hidup

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Laryngopharyngeal reflux disease in singers: Pathophysiology, clinical findings and perspectives of a new patient-reported outcome instrument

Cited by 26 publications

References 50 publications

Association between laryngopharyngeal reflux and benign vocal folds lesions: A systematic review.

Association between laryngopharyngeal reflux and benign vocal folds lesions: A systematic review.

Correlation and Influencing Factors Between Laryngopharyngeal Reflux Disease and Sleep Status in Patients

Proton pump inhibitors effect on the quality of life of patients with laryngopharyngeal reflux

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